Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 318-324 |
| Number of pages | 7 |
| Journal | Health Psychology |
| Volume | 38 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 2019 |
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Keywords
- decision making
- fatigue
- clinical decisions
- nurses
- efficiency
- Humans
- Nurses
- Adult
- Female
- Male
- Fatigue/diagnosis
- Decision Making/ethics
- TELEPHONE HELPLINE NURSES
- PERFORMANCE
- SELF
- MODEL
- IMPACT
- EGO-DEPLETION
- STRESS
- Decision making
- Fatigue
- Efficiency
- Clinical decisions
ASJC Scopus subject areas
- Psychiatry and Mental health
- Applied Psychology
Cite this
Clinical decisions and time since rest break : An analysis of decision fatigue in nurses. / Allan, Julia L. (Corresponding Author); Johnston, Derek W.; Powell, Daniel J. H.; Farquharson, Barbara; Jones, Martyn C.; Leckie, George; Johnston, Marie.
In: Health Psychology, Vol. 38, No. 4, 04.2019, p. 318-324.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clinical decisions and time since rest break
T2 - An analysis of decision fatigue in nurses
AU - Allan, Julia L.
AU - Johnston, Derek W.
AU - Powell, Daniel J. H.
AU - Farquharson, Barbara
AU - Jones, Martyn C.
AU - Leckie, George
AU - Johnston, Marie
N1 - The parent study was funded by the Scottish Government’s Chief Scientist Office (CZH/4/394).
PY - 2019/4
Y1 - 2019/4
N2 - Objective: The present study investigates whether nurses working for a national medical telephone helpline show evidence of “decision fatigue,” as measured by a shift from effortful to easier and more conservative decisions as the time since their last rest break increases. Method: In an observational, repeated-measures study, data from approximately 4,000 calls to 150 nurses working for the Scottish NHS 24 medical helpline (37% of the national workforce) were modeled to determine whether the likelihood of a nurse’s decision to refer a patient to another health professional the same day (the clinically safest but most conservative and resource inefficient decision) varied according to the number of calls taken/time elapsed since a nurse’s last rest break and/or since the start of shift. Analyses used mixed-effect logistic regression. Results: For every consecutive call taken since last rest break, the odds of nurses making a conservative management decision (i.e., arranging for callers to see another health professional the same day) increased by 5.5% (p = .001, 95% confidence interval [CI: 2.2, 8.8]), an increase in odds of 20.5% per work hour (p < .001, 95% CI [9.1, 33.2]) or 49.0% (on average) from immediately after 1 break to immediately before the next. Decision-making was not significantly related to general or cumulative workload (calls or time elapsed since start of shift). Conclusions: Every consecutive decision that nurses make since their last break produces a predictable shift toward more conservative, and less resource-efficient, decisions. Theoretical models of cognitive fatigue can elucidate how and why this shift occurs, helping to identify potentially modifiable determinants of patient care. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
AB - Objective: The present study investigates whether nurses working for a national medical telephone helpline show evidence of “decision fatigue,” as measured by a shift from effortful to easier and more conservative decisions as the time since their last rest break increases. Method: In an observational, repeated-measures study, data from approximately 4,000 calls to 150 nurses working for the Scottish NHS 24 medical helpline (37% of the national workforce) were modeled to determine whether the likelihood of a nurse’s decision to refer a patient to another health professional the same day (the clinically safest but most conservative and resource inefficient decision) varied according to the number of calls taken/time elapsed since a nurse’s last rest break and/or since the start of shift. Analyses used mixed-effect logistic regression. Results: For every consecutive call taken since last rest break, the odds of nurses making a conservative management decision (i.e., arranging for callers to see another health professional the same day) increased by 5.5% (p = .001, 95% confidence interval [CI: 2.2, 8.8]), an increase in odds of 20.5% per work hour (p < .001, 95% CI [9.1, 33.2]) or 49.0% (on average) from immediately after 1 break to immediately before the next. Decision-making was not significantly related to general or cumulative workload (calls or time elapsed since start of shift). Conclusions: Every consecutive decision that nurses make since their last break produces a predictable shift toward more conservative, and less resource-efficient, decisions. Theoretical models of cognitive fatigue can elucidate how and why this shift occurs, helping to identify potentially modifiable determinants of patient care. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
KW - decision making
KW - fatigue
KW - clinical decisions
KW - nurses
KW - efficiency
KW - Humans
KW - Nurses
KW - Adult
KW - Female
KW - Male
KW - Fatigue/diagnosis
KW - Decision Making/ethics
KW - TELEPHONE HELPLINE NURSES
KW - PERFORMANCE
KW - SELF
KW - MODEL
KW - IMPACT
KW - EGO-DEPLETION
KW - STRESS
KW - Decision making
KW - Fatigue
KW - Efficiency
KW - Clinical decisions
UR - http://www.scopus.com/inward/record.url?scp=85063497155&partnerID=8YFLogxK
UR - http://www.mendeley.com/research/clinical-decisions-time-since-rest-break-analysis-decision-fatigue-nurses
U2 - 10.1037/hea0000725
DO - 10.1037/hea0000725
M3 - Article
C2 - 30896218
AN - SCOPUS:85063497155
VL - 38
SP - 318
EP - 324
JO - Health Psychology
JF - Health Psychology
SN - 0278-6133
IS - 4
ER -